| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | AETNA LIFE INSURANCE CO. | -$10K | $171K | $161K | 1.31% |
| THE PLEXUS GROUPE LLC3 Filed as: PLEXUS GROUPE LLC (THE) | 21805 FIELD PARKWAY SUITE 300 DEER PARK, IL 60010 | AETNA LIFE INSURANCE CO. | $49K | $36K | $85K | 0.70% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON OF PENNSYLVANIA, INC. | 12377 MERIT DRIVE SUITE 1200 DALLAS, TX 75251 | AETNA LIFE INSURANCE CO. | $52 | — | $52 | 0.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | 901 NORTH GLEBE ROAD ARLINGTON, VA 22203 | AETNA LIFE INSURANCE CO. | -$34K | — | -$34K | -0.28% |
| LOURDES ESPINET ORTIZ3 | PO BOX 361458 SAN JUAN, PR 009361458 | TRIPLE-S SALUD, INC | $57K | — | $57K | 5.00% |
| P.S.H. INSURANCE, INC.3 Filed as: P.S.H. INSURANCE | 737 BISHOP ST SUITE 2120 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $15K | — | $15K | 4.82% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 15,755 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 15,755 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRIPLE-S SALUD, INC | 401 | $1.5M |
| Dental(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 15,755 | $13.7M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 15,755 | $12.6M |
| Life insurance | AETNA LIFE INSURANCE CO. | 15,755 | $12.3M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 15,755 | $12.3M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 15,755 | $12.3M |
| Prescription drug(2 contracts, 2 carriers) | TRIPLE-S SALUD, INC | 401 | $1.5M |
| Other | AETNA LIFE INSURANCE CO. | 15,755 | $12.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,755 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.